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Liang JH, Liu ML, Pu YQ, Wang C, Huang S, Jiang N, Hu LX, Zhang YS, Gui ZH, Pu XY, Huang SY, Chen YJ. Contribution of individual and cumulative social determinants of health underlying gender disparities in periodontitis in a representative US population: A cross-sectional NHANES study. J Clin Periodontol 2024; 51:558-570. [PMID: 38200631 DOI: 10.1111/jcpe.13941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 12/15/2023] [Accepted: 12/21/2023] [Indexed: 01/12/2024]
Abstract
AIM To examine the impact of both individual and cumulative social determinants of health (SDoH) on the likelihood of developing periodontitis, while also exploring any gender disparities in this relationship. MATERIALS AND METHODS Data of self-reported SDoH domains and sub-items based on Healthy People 2030 were obtained from the U.S. National Health and Nutrition Examination Surveys between 1999 and 2014. Logistic regression models, weighted by survey responses, were used to examine the relationship between SDoH (including eight sub-items and the cumulative number of unfavourable SDoH) and periodontitis. The results were further analysed by gender. RESULTS A total of 18,075 participants (8867 males and 9208 females) were included in the main analysis, of which 5814 (32.2%) had periodontitis. The study found that certain unfavourable SDoH were individually associated with higher odds of periodontitis, and the cumulative number of unfavourable SDoH was positively linked to the odds of developing periodontitis. Furthermore, males exposed to more unfavourable SDoH appeared to be more susceptible to developing periodontitis than females. CONCLUSIONS The findings suggest that unfavourable SDoH, especially when they accumulate, are associated with an increased odds of periodontitis and contribute to gender disparities within the U.S. POPULATION
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Affiliation(s)
- Jing-Hong Liang
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Mei-Ling Liu
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Ying-Qi Pu
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Cong Wang
- Department of Radiology, Henan Provincial People's Hospital, Zhengzhou, People's Republic of China
| | - Shan Huang
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Nan Jiang
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Li-Xin Hu
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Yu-Shan Zhang
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Zhao-Huan Gui
- Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, Guangdong Provincial Engineering Technology Research Center of Environmental and Health risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Guangzhou, People's Republic of China
| | - Xue-Ya Pu
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Shao-Yi Huang
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Ya-Jun Chen
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, People's Republic of China
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2
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Fleming E, Taylor GW, Neighbors HW. Systemic racism and racial inequities in periodontal health: The long journey from upstream determinants to downstream treatment. Periodontol 2000 2024. [PMID: 38501675 DOI: 10.1111/prd.12559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Accepted: 01/11/2024] [Indexed: 03/20/2024]
Abstract
Racial disparities in the prevalence of periodontal disease are consistent and persistent. The epidemiology of periodontal disease demonstrates racial inequities: non-Hispanic Black (14.7%), Mexican American (13.4%), and other Hispanic adults (7.8%) experience a higher prevalence of severe periodontal disease than non-Hispanic White adults (5.9%). Epidemiologic and clinical research on periodontal health suffers from the same problem that has plagued the health equity movement, an over emphasis on describing racial inequities coupled with few interventions that reduce racial health inequity. Over the decades that racial inequities in periodontal disease have been observed, many have argued that systemic racism is the fundamental driver of racial health inequity. This paper interrogates the roles of systemic racism, dental education, clinical treatment, and patient behavior in periodontal disease. We describe how, together, these mechanisms contribute to racial disparities in periodontal outcomes. However, it is insufficient for oral health equity scientists to only describe and discuss the negative effects of systemic racism. The imperative is to create antiracist strategies designed to eliminate systemic racism. Health equity scientists must also specify how dental systems operate in a racist manner and create effective clinical strategies designed to reduce racial disparities in periodontal disease.
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Affiliation(s)
- Eleanor Fleming
- Department of Dental Public Health, University of Maryland School of Dentistry, Baltimore, Maryland, USA
| | - George W Taylor
- Department of Preventive and Restorative Dental Sciences, Division of Oral Epidemiology and Dental Public Health, University of California San Francisco School of Dentistry, San Francisco, California, USA
| | - Harold Woody Neighbors
- Department of Social, Behavioral, and Population Sciences, School of Public Health and Tropical Medicine, Tulane University, New Orleans, Louisiana, USA
- Department of Health Behavior and Health Education, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
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3
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Tsai KZ, Huang CM, Wang HS, Sui X, Lavie CJ, Lin GM. Does the guideline-based physical activity level for cardiovascular health also benefit periodontal health? J Dent Sci 2024; 19:46-50. [PMID: 38303861 PMCID: PMC10829664 DOI: 10.1016/j.jds.2023.05.036] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 05/31/2023] [Indexed: 02/03/2024] Open
Abstract
Abstract Background/purpose It is unclear about whether the guideline-based physical activity (PA) level for cardiovascular health also benefits periodontal health. Therefore, this study aimed to clarify the association between guideline-based PA levels and periodontitis in young adults. Materials and methods This was a cross-sectional study which included 334 military participants, aged 18-44 years in Taiwan. The PA level was assessed by total running time per week (wk) in the past 6 months from a self-reported questionnaire, and was classified as moderate intensity PA <150, 150-299, and ≥300 min/wk according to the American guideline for cardiovascular health. Periodontitis was defined based on the 2017 World Workshop. Multiple logistic regression analysis was used to determine the association with adjustment for age, sex, educational level, tobacco smoking, alcohol intake, body mass index, waist circumference, blood pressure and teeth brushing frequency. Results As compared to the PA: 150-299 min/wk, the PA <150 min/wk was associated with a greater possibility of periodontitis (odds ratio (OR): 2.45 (95% confidence interval (CI): 1.24-4.82), whereas the PA ≥300 min/wk was not associated with periodontitis (OR: 0.98 (95% CI: 0.13-1.09)) in young adults. Conclusion The guideline-based moderate intensity PA level ≥150 min/wk is found to have superior periodontal health in young adults. However, there is no additional benefit in more exercise time to obtain better periodontal health when the suggested PA level has been achieved.
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Affiliation(s)
- Kun-Zhe Tsai
- Department of Medicine, Hualien Armed Forces General Hospital, Hualien, Taiwan
- Department of Stomatology of Periodontology, Mackay Memorial Hospital, Taipei, Taiwan
- Department of Dentistry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Chen-Ming Huang
- Department of Cardiovascular Surgery, Mennonite Christian Hospital, Hualien City, Taiwan
| | - Hui-Shang Wang
- Division of Cardiology, Department of Internal Medicine, Hualien Tzu Chi Hospital, Hualien City, Taiwan
| | - Xuemei Sui
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Carl J. Lavie
- John Ochsner Heart and Vascular Institute, Ochsner Clinical School, The University of Queensland School of Medicine, New Orleans, LA, USA
| | - Gen-Min Lin
- Department of Medicine, Hualien Armed Forces General Hospital, Hualien, Taiwan
- Department of Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
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4
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Raeesi V, Mohammadi Moghaddam M, Naghavi A, Mozafari G. The effect of scaling and root planning on the periodontal condition in hemodialysis patients: A clinical trial study. Health Sci Rep 2023; 6:e1520. [PMID: 37636284 PMCID: PMC10448737 DOI: 10.1002/hsr2.1520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 08/06/2023] [Accepted: 08/07/2023] [Indexed: 08/29/2023] Open
Abstract
Background and Aims Periodontitis is very common in kidney patients undergoing hemodialysis. The two diseases interact with each other so that kidney failure exacerbates periodontal disease and periodontal disease increases the severity of the renal failure. This study aimed to compare the effect of scaling and root planning on the periodontal status of hemodialysis patients and the healthy control group. Methods A clinical trial study of 60 subjects, 30 subjects in the dialysis group with chronic periodontitis, and 30 with chronic periodontitis who were systemically healthy was conducted. After a health education session, gingival pocket depth (PD) measurement, and clinical attachment level (CAL), scaling was performed for both groups. Then, the mentioned indices were measured consequently, at 4 and 8 weeks of treatment. Improvement in both groups was analyzed by Mann-Whitney and paired sample t-test at the significance level of 0.05 by SPSS software. Results In both groups, the decrease in PD and CAL was steadily observed from the first to the third time and the changes from the first to the second and the first to the third time were significant however it was not significant between the second and third time. Mean PD and CAL in the dialysis group were higher than in the nondialysis group, which was significant (p < 0.001) for the mean PD. The mean improvement of PD and CAL in dialysis patients was 14.31 ± 10.48 and 17.60 ± 7.83%, respectively, and the mean improvement of PD in the nondialysis group was significantly higher than in the dialysis group (p = 0.008). Conclusion Periodontal treatment (scaling) causes more improvement in periodontal clinical parameters in healthy people with periodontitis than in dialysis patients.
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Affiliation(s)
- Vajehallah Raeesi
- Department of Internal Medicine, School of Medicine, Cardiovascular Diseases Research CenterBirjand University of Medical SciencesBirjandIran
| | | | - Ali Naghavi
- Department of Periodontics, School of DentistryBirjand University of Medical SciencesBirjandIran
| | - Ghazale Mozafari
- Department of Periodontics, School of DentistryBirjand University of Medical SciencesBirjandIran
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Wang BY, Burgardt G, Parthasarathy K, Ho DK, Weltman RL, Tribble GD, Hong J, Cron S, Xie H. Influences of race/ethnicity in periodontal treatment response and bacterial distribution, a cohort pilot study. FRONTIERS IN ORAL HEALTH 2023; 4:1212728. [PMID: 37377523 PMCID: PMC10291508 DOI: 10.3389/froh.2023.1212728] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 05/29/2023] [Indexed: 06/29/2023] Open
Abstract
Objectives Periodontitis disproportionately affects different racial and ethnic populations. We have previously reported the higher levels of Porphyromonas gingivalis and lower ratios of Streptococcus cristatus to P. gingivalis may contribute to periodontal health disparities. This prospective cohort study was designed to investigate if ethnic/racial groups responded differently to non-surgical periodontal treatment and if the treatment outcomes correlated to the bacterial distribution in patients with periodontitis before treatment. Methods This prospective cohort pilot study was carried out in an academic setting, at the School of Dentistry, University of Texas Health Science Center at Houston. Dental plaque was collected from a total of 75 African Americans, Caucasians and Hispanics periodontitis patients in a 3-year period. Quantitation of P. gingivalis and S. cristatus was carried out using qPCR. Clinical parameters including probing depths and clinical attachment levels were determined before and after nonsurgical treatment. Data were analyzed using one-way ANOVA, the Kruskal-Wallis test, the paired samples t-test and the chi-square test. Results The gains in clinical attachment levels after treatment significantly differed amongst the 3 groups-Caucasians responded most favorably, followed by African-Americans, lastly Hispanics, while numbers of P. gingivalis were highest in Hispanics, followed by African-Americans, and lowest in Caucasians (p = 0.015). However, no statistical differences were found in the numbers of S. cristatus amongst the 3 groups. Conclusion Differential response to nonsurgical periodontal treatment and distribution of P. gingivalis are present in different ethnic/racial groups with periodontitis.
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Affiliation(s)
- Bing-Yan Wang
- School of Dentistry, University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Grayson Burgardt
- School of Dentistry, University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Kavitha Parthasarathy
- School of Dentistry, University of Texas Health Science Center at Houston, Houston, TX, United States
- Arthur A. Dugoni School of Dentistry, University of the Pacific, San Francisco, CA, United States
| | - Daniel K. Ho
- School of Dentistry, University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Robin L. Weltman
- School of Dentistry, University of Texas Health Science Center at Houston, Houston, TX, United States
- Department of Clinical Sciences, University of Nevada, Las Vegas, NV, United States
| | - Gena D. Tribble
- School of Dentistry, University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Jianming Hong
- School of Dentistry, University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Stanley Cron
- School of Nursing, University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Hua Xie
- School of Dentistry, Meharry Medical College, Nashville, TN, United States
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Filgueiras LV, Konflanz W, Haas AN, Celeste RK. Assessment of the contextual effects on the prevalence of periodontitis: a systematic review. Braz Oral Res 2023; 36:e0125. [PMID: 36651384 DOI: 10.1590/1807-3107bor-2022.vol36.0125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 06/02/2021] [Indexed: 01/17/2023] Open
Abstract
This study reviews the influence of contextual factors on periodontitis based on a systematic search of studies recorded in the PubMed, Scopus, Web of Science, and EMBASE databases. Periodontitis was assessed by clinical attachment loss and probing depth for studies with data on the socioeconomic status (SES) of a specific area (area-level SES) or dental care service (service-level) in a catchment area among individuals aged 18 and over. Two independent reviewers performed study selection, data extraction, and assessment of methodological quality. Of the 646 articles identified, 13 were included in the systematic review, representing 101,362 individuals from five countries (USA, UK, Brazil, China, and Uruguay). A higher prevalence of periodontitis was described in lower SES neighborhoods, more deprived postcodes, and poorer provinces. Gini Index results were mixed and inconclusive. Three studies showed that higher coverage of primary dental care at the municipal level was associated with a lower prevalence of periodontitis. Contextual factors at the area-level SES and dental care service might influence periodontitis, but the existing evidence is unclear. The contextual effect is important for periodontal health and may contribute to the prevalence of periodontitis, independent of well-known risk factors and individual levels.
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Affiliation(s)
- Leonardo Vilar Filgueiras
- Universidade Federal do Rio Grande do Sul - UFRGS, Department of Preventive and Social Dentistry, Porto Alegre, RS, Brazil
| | - Willian Konflanz
- Universidade Federal do Rio Grande do Sul - UFRGS, Department of Periodontology, Porto Alegre, RS, Brazil
| | - Alex Nogueira Haas
- Universidade Federal do Rio Grande do Sul - UFRGS, Department of Periodontology, Porto Alegre, RS, Brazil
| | - Roger Keller Celeste
- Universidade Federal do Rio Grande do Sul - UFRGS, Department of Preventive and Social Dentistry, Porto Alegre, RS, Brazil
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Marruganti C, Baima G, Grandini S, Graziani F, Aimetti M, Sanz M, Romandini M. Leisure-time and occupational physical activity demonstrate divergent associations with periodontitis: A population-based study. J Clin Periodontol 2023; 50:559-570. [PMID: 36592958 DOI: 10.1111/jcpe.13766] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 12/27/2022] [Accepted: 12/29/2022] [Indexed: 01/04/2023]
Abstract
AIM To evaluate the association between leisure-time/occupational physical activity (LTPA/OPA) and periodontitis in a nationally representative sample of the U.S. POPULATION MATERIALS AND METHODS Data from 10,679 adults were retrieved from NHANES 2009-2014 database. Physical activity was assessed through the Global Physical Activity Questionnaire, and accordingly, subjects were classified as performing either high or low LTPA/OPA. Periodontal status was assessed through a full-mouth periodontal examination, and subjects were classified according to the AAP/CDC criteria (no, mild, moderate, or severe periodontitis). Simple and multiple regression analyses were applied to study the association between LTPA/OPA and periodontitis/severe periodontitis. RESULTS Multiple regression analyses identified high LTPA as a protective indicator for periodontitis (odds ratio [OR] = 0.81; 95% confidence interval [CI]: 0.72-0.92), while high OPA was found to be a significant risk indicator (OR = 1.16; 95% CI: 1.04-1.30). The combination low LTPA/high OPA showed a cumulative independent association with periodontitis (OR = 1.47; 95% CI: 1.26-1.72). Moreover, both high LTPA (OR = 0.72; 95% CI: 0.58-0.90) and high OPA (OR = 1.29; 95% CI: 1.09-1.53) were significantly associated with stronger estimates of severe periodontitis; the same was observed for the combination of low LTPA/high OPA (OR = 1.66; 95% CI: 1.29-2.15). CONCLUSIONS LTPA and OPA showed divergent associations with periodontitis.
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Affiliation(s)
- Crystal Marruganti
- Unit of Periodontology, Endodontology and Restorative Dentistry, Department of Medical Biotechnologies, University of Siena, Siena, Italy.,Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy.,Sub-Unit of Periodontology, Halitosis and Periodontal Medicine, University Hospital of Pisa, Pisa, Italy
| | - Giacomo Baima
- Department of Surgical Sciences, C.I.R. Dental School, University of Turin, Turin, Italy.,Polytechnic of Turin, Turin, Italy
| | - Simone Grandini
- Unit of Periodontology, Endodontology and Restorative Dentistry, Department of Medical Biotechnologies, University of Siena, Siena, Italy
| | - Filippo Graziani
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy.,Sub-Unit of Periodontology, Halitosis and Periodontal Medicine, University Hospital of Pisa, Pisa, Italy
| | - Mario Aimetti
- Department of Surgical Sciences, C.I.R. Dental School, University of Turin, Turin, Italy
| | - Mariano Sanz
- Faculty of Odontology, University Complutense, Madrid, Spain
| | - Mario Romandini
- Faculty of Odontology, University Complutense, Madrid, Spain
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8
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Filgueiras LV, Cabreira FDS, Pilotto LM, Celeste RK. Association between socioeconomic contextual factor, dental care service availability, and prevalence of periodontitis in Brazil: a multilevel analysis. CAD SAUDE PUBLICA 2023; 39:e00201522. [PMID: 37132717 DOI: 10.1590/0102-311xen201522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 03/02/2023] [Indexed: 05/04/2023] Open
Abstract
This study aimed to examine the effect of dental care services on periodontitis cases in Brazilian municipalities. The sample comprised 3,426 individuals aged 35-44 years. Moderate to severe periodontitis with clinical attachment loss and probing depth was the dependent variable, both > 3mm. Its exploratory variables were grouped into four categories: (1) individual characteristics; (2) contextual development indicators; (3) health service and structural factors; and (4) dental care use. Data were collected using the SBBrasil 2010 Project, the Brazilian Institute of Geography and Statistics, the Brazilian Information System of Primary and Secondary Care, and the Program to Improve Access and Quality of Dental Specialization Centers (PMAQ-CEO). Multilevel logistic regression was used to assess associations of periodontitis with individual and context variables. Municipalities with > 1 CEO or > 1 of any centers were associated with periodontitis, with OR = 0.97 (95%CI: 0.55-1.71) and OR = 0.41 (95%CI: 0.17-0.97), respectively. Prevalence of periodontitis was more likely in older people, lower education levels, and individuals that sought dental visits for pain/extraction and periodontal treatment. Other dental care services availability were not associated with the prevalence of periodontitis.
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Wang BY, Cao A, Ho MH, Wilus D, Sheng S, Meng HW, Guerra E, Hong J, Xie H. Identification of microbiological factors associated with periodontal health disparities. Front Cell Infect Microbiol 2023; 13:1137067. [PMID: 36875522 PMCID: PMC9978005 DOI: 10.3389/fcimb.2023.1137067] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 02/07/2023] [Indexed: 02/18/2023] Open
Abstract
The present study aimed at identifying risk factors associated with periodontitis development and periodontal health disparities with emphasis on differential oral microbiota. The prevalence of periodontitis is recently rising dentate adults in the US, which presents a challenge to oral health and overall health. The risk of developing periodontitis is higher in African Americans (AAs), and Hispanic Americans (HAs) than in Caucasian Americans (CAs). To identify potentially microbiological determinations of periodontal health disparities, we examined the distribution of several potentially beneficial and pathogenic bacteria in the oral cavities of AA, CA, and HA study participants. Dental plaque samples from 340 individuals with intact periodontium were collected prior to any dental treatment, and levels of some key oral bacteria were quantitated using qPCR, and the medical and dental histories of participants were obtained retrospectively from axiUm. Data were analyzed statistically using SAS 9.4, IBM SPSS version 28, and R/RStudio version 4.1.2. Amongst racial/ethnic groups: 1) neighborhood medium incomes were significantly higher in the CA participants than the AA and the HA participants; 2) levels of bleeding on probing (BOP) were higher in the AAs than in the CAs and HAs; 3) Porphyromonas gingivalis levels were higher in the HAs compared to that in the CAs; 4) most P. gingivalis detected in the AAs were the fimA genotype II strain that was significantly associated with higher BOP indexes along with the fimA type IV strain. Our results suggest that socioeconomic disadvantages, higher level of P. gingivalis, and specific types of P. gingivalis fimbriae, particularly type II FimA, contribute to risks for development of periodontitis and periodontal health disparities.
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Affiliation(s)
- Bing-Yan Wang
- School of Dentistry, University of Texas Health Science Center at Houston, Houston, TX, United States
- *Correspondence: Bing-Yan Wang, ; Hua Xie,
| | - Aize Cao
- School of Applied Computational Sciences, Meharry Medical College, Nashville, TN, United States
| | - Meng-Hsuan Ho
- School of Dentistry, Meharry Medical College, Nashville, TN, United States
| | - Derek Wilus
- School of Graduate Studies, Meharry Medical College, Nashville, TN, United States
| | - Sally Sheng
- School of Dentistry, University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Hsiu-Wan Meng
- School of Dentistry, University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Elissa Guerra
- School of Dentistry, University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Jianming Hong
- School of Dentistry, University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Hua Xie
- School of Dentistry, Meharry Medical College, Nashville, TN, United States
- *Correspondence: Bing-Yan Wang, ; Hua Xie,
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10
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Walther C, Spinler K, Borof K, Kofahl C, Heydecke G, Seedorf U, Beikler T, Terschüren C, Hajek A, Aarabi G. Evidence from the Hamburg City Health Study - association between education and periodontitis. BMC Public Health 2022; 22:1662. [PMID: 36056348 PMCID: PMC9438138 DOI: 10.1186/s12889-022-14096-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 08/25/2022] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE Large-scale population-based studies regarding the role of education in periodontitis are lacking. Thus, the aim of the current study was to analyze the potential association between education and periodontitis with state of the art measured clinical phenotypes within a large population-based sample from northern Germany. MATERIAL & METHODS The Hamburg City Health Study (HCHS) is a population-based cohort study registered at ClinicalTrial.gov (NCT03934957). Oral health was assessed via plaque-index, probing depth, gingival recession and gingival bleeding. Periodontitis was classified according to Eke & Page. Education level was determined using the International Standard Classification of Education (ISCED-97) further categorized in "low, medium or high" education. Analyses for descriptive models were stratified by periodontitis severity. Ordinal logistic regression models were stepwise constructed to test for hypotheses. RESULTS Within the first cohort of 10,000 participants, we identified 1,453 with none/mild, 3,580 with moderate, and 1,176 with severe periodontitis. Ordinal regression analyses adjusted for co-variables (age, sex, smoking, diabetes, hypertension and migration) showed that the education level (low vs. high) was significantly associated with periodontitis (OR: 1.33, 95% CI: 1.18;1.47). CONCLUSION In conclusion, the current study revealed a significant association between the education level and periodontitis after adjustments for a set of confounders. Further research is needed to develop strategies to overcome education related deficits in oral and periodontal health.
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Affiliation(s)
- Carolin Walther
- Department of Periodontics, Preventive and Restorative Dentistry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - Kristin Spinler
- Department of Periodontics, Preventive and Restorative Dentistry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,Institute of Medical Sociology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Katrin Borof
- Department of Periodontics, Preventive and Restorative Dentistry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Christopher Kofahl
- Institute of Medical Sociology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Guido Heydecke
- Department of Prosthetic Dentistry, Center for Dental and Oral Medicine, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
| | - Udo Seedorf
- Department of Periodontics, Preventive and Restorative Dentistry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Thomas Beikler
- Department of Periodontics, Preventive and Restorative Dentistry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Claudia Terschüren
- Institute for Occupational and Maritime Medicine (ZfAM), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Andre Hajek
- Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Ghazal Aarabi
- Department of Periodontics, Preventive and Restorative Dentistry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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11
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Khajavi A, Radvar M, Moeintaghavi A. Socioeconomic determinants of periodontitis. Periodontol 2000 2022; 90:13-44. [PMID: 35950737 DOI: 10.1111/prd.12448] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- Amin Khajavi
- Craniomaxillofacial Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehrdad Radvar
- Department of Periodontology, Mashhad Dental School, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Amir Moeintaghavi
- Department of Periodontology, Mashhad University of Medical Sciences, Mashhad, Iran
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Selvaraj S, Naing NN, Wan-Arfah N, Djearamane S, Wong LS, Subramaniyan V, Fuloria NK, Sekar M, Fuloria S, de Abreu MHNG. Epidemiological Factors of Periodontal Disease Among South Indian Adults. J Multidiscip Healthc 2022; 15:1547-1557. [PMID: 35898950 PMCID: PMC9309273 DOI: 10.2147/jmdh.s374480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Accepted: 06/29/2022] [Indexed: 11/23/2022] Open
Abstract
Introduction Oral conditions exist worldwide, and are related with astounding morbidity. Indian adults’ incidence of mild and moderate periodontal conditions was nearly 25%, while about 19% of adults experience severe periodontitis. Objective The aim of this study was to analyse epidemiological factors of periodontal disease among a south Indian population based on the role of sociodemographic factors, habitual factors and set of oral health knowledge, attitude, and behaviour measures. Methods A sample of 288 participants above 18 years of age residing in Tamil Nadu, India took part in this cross-sectional study. Based on WHO criteria, periodontal disease was measured in our study. Age, ethnicity, smoking, education, and oral health behavior were found to be the covariates. Ordinal logistic regression analysis using R version 3.6.1 was utilized to study the various factors that influence periodontal disease among south Indian adults. Results Various demographic factors such as age between 25 and 34 years (AOR = 2.25; 95% CI 1.14–4.55), 35–44 years (AOR = 1.80; 95% CI 0.89–3.64), ≥ 45 years old (AOR = 2.89; 95% CI 1.41–6.01), ethnicity (AOR = 2.71; 95% CI 1.25–5.81), smoking (AOR = 0.38; 95% CI 0.16–0.65), primary level education (AOR = 0.07; 95% CI 0.01–0.50) high school level education (AOR = 0.06; 95% CI 0.01–0.27), university level education (AOR = 0.08; 95% CI 0.01–0.36) and an individual’s oral health behavior (AOR = 0.59; 95% CI 0.32–1.08) were found to be related with periodontal disease among the south Indian population. The maximum log likelihood residual deviance value was 645.94 in the final model. Conclusion Based on our epidemiological findings, sociodemographic, habitual factors and oral health behavior play a vital role in an individual’s periodontal status among south Indian adults. An epidemiological model derived from the factors from our study will help to bring better understanding of the disease and to implement various preventive strategies to eliminate the causative factors.
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Affiliation(s)
- Siddharthan Selvaraj
- Faculty of Medicine, Medical Campus, Universiti Sultan Zainal Abidin, Kuala Terengganu, Terengganu, 20400, Malaysia.,Faculty of Dentistry, AIMST University, Bedong, Kedah, 08100, Malaysia
| | - Nyi Nyi Naing
- Faculty of Medicine, Medical Campus, Universiti Sultan Zainal Abidin, Kuala Terengganu, Terengganu, 20400, Malaysia
| | - Nadiah Wan-Arfah
- Faculty of Health Sciences, Universiti Sultan Zainal Abidin, Kuala Terengganu, Terengganu, 20400, Malaysia
| | - Sinouvassane Djearamane
- Department of Biomedical Science, Faculty of Science, Universiti Tunku Abdul Rahman, Kampar, Perak, 31900, Malaysia
| | - Ling Shing Wong
- Faculty of Health and Life Sciences, INTI International University, Nilai, 71800, Malaysia
| | - Vetriselvan Subramaniyan
- Faculty of Medicine, Bioscience and Nursing, MAHSA University, Jen jarom, Selangor, 42610, Malaysia
| | | | - Mahendran Sekar
- Department of Pharmaceutical Chemistry, Faculty of Pharmacy and Health Sciences, Royal College of Medicine Perak, Universiti Kuala Lumpur, Ipoh, Perak, 30450, Malaysia
| | - Shivkanya Fuloria
- Faculty of Pharmacy, AIMST University, Bedong, Kedah, 08100, Malaysia
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Wang BY, Lu T, Cai Q, Ho MH, Sheng S, Meng HW, Arsto L, Hong J, Xie H. Potential Microbiological Risk Factors Associated With Periodontitis and Periodontal Health Disparities. Front Cell Infect Microbiol 2021; 11:789919. [PMID: 34869082 PMCID: PMC8637773 DOI: 10.3389/fcimb.2021.789919] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Accepted: 10/29/2021] [Indexed: 11/13/2022] Open
Abstract
Periodontitis disproportionately affects different racial and ethnic populations. In this study, we used qPCR to determine and compare oral microbial profiles in dental plaque samples from 191 periodontitis patients of different ethnic/racial backgrounds. We also obtained the periodontal parameters of these patients retrospectively using axiUm and performed statistical analysis using SAS 9.4. We found that in this patient cohort, neighborhood median incomes were significantly higher among Caucasians Americans (CAs) than among African Americans (AAs) and Hispanic Americans (HAs). Levels of total bacteria and Porphyromonas gingivalis, a keystone periodontal pathogen, were not evenly distributed among the three groups. We confirmed our previous findings that Streptococcus cristatus reduces P. gingivalis virulence potential and likely serves as a beneficial bacterium. We also showed the ratio of S. cristatus to P. gingivalis to be significantly higher in CAs than in HAs and AAs. Our results suggest that higher levels of P. gingivalis and lower ratios of S. cristatus to P. gingivalis may contribute to periodontal health disparities.
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Affiliation(s)
- Bing-Yan Wang
- School of Dentistry, University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Tom Lu
- Department of Mathematics and Statistics, Texas Tech University, Lubbock, TX, United States
| | - Qiuyin Cai
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, TN, United States
| | - Meng-Hsuan Ho
- School of Dentistry, Meharry Medical College, Nashville, TN, United States
| | - Sally Sheng
- School of Dentistry, University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Hsiu-Wan Meng
- School of Dentistry, University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Laura Arsto
- School of Dentistry, University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Jianming Hong
- School of Dentistry, University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Hua Xie
- School of Dentistry, Meharry Medical College, Nashville, TN, United States
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Wei Y, Wang Z, Lei L, Chen L. Global burden of periodontal disease and its relation with socioeconomic development during 1990-2019. Zhejiang Da Xue Xue Bao Yi Xue Ban 2021; 50:545-552. [PMID: 34986536 DOI: 10.3724/zdxbyxb-2021-0321] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
To analyze the global burden of periodontal disease and its relation with socioeconomic development. Data of global disability-adjusted life year (DALY) due to periodontal disease and human development index (HDI) from 1990 to 2019 were obtained from Global Health Data Exchange (GHDx) and human development reports. The trend of the global burden of periodontal disease from 1990 to 2019 was described. The correlation between age-standardized DALY rates and HDI were examined in 2019, and between-country periodontal disease burden inequality from 1990 to 2019 was measured using health-related Gini coefficients and concentration indexes. From 1990 to 2019, the global DALY rate due to periodontal disease increased from 78.63 to 85.48, and the epidemiological burden did not increase significantly. Statistical differences were found across different HDI categories for age-standardized DALY rates of periodontal disease ( 44.315, <0.01) in 2019. Linear regression analysis also revealed a negative correlation between age-standardized DALY rate of periodontal disease and HDI ( = -0.417, <0.01) . Gini coefficients decreased from 0.361 to 0.281 and concentration indexes fell from 0.0339 to -0.0538 between 1990 and 2019. The global burden of periodontal disease did not increase between 1990 and 2019, though the socioeconomic-associated inequality still existed. The burden of periodontal disease was more concentrated in less developed countries, and the socioeconomic-associated inequality has increased since 2000.
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Affiliation(s)
- Yingming Wei
- Department of Periodontics, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China
| | - Zhongxiu Wang
- Department of Periodontics, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China
| | - Lihong Lei
- Department of Periodontics, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China
| | - Lili Chen
- Department of Periodontics, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China
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Selvaraj S, Naing NN, Wan-Arfah N, de Abreu MHNG. Demographic and Habitual Factors of Periodontal Disease among South Indian Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18157910. [PMID: 34360201 PMCID: PMC8345463 DOI: 10.3390/ijerph18157910] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 07/17/2021] [Accepted: 07/21/2021] [Indexed: 12/23/2022]
Abstract
The aim of this study was to evaluate the performance of a set of sociodemographic and habits measures on estimating periodontal disease among south Indian adults. This cross-sectional study was carried out among 288 individuals above 18 years old in Tamil Nadu, India. The outcome of the study was periodontal disease, measured by WHO criteria. The covariates were age, ethnicity, smoking and alcohol habit. The assessment of factors predicting periodontal disease was carried out by multiple logistic regression analysis using R version 3.6.1. The demographic factors like age group (AOR = 3.56; 95% CI 1.69-7.85), ethnicity (AOR = 6.07; 95% CI 2.27-18.37), non-alcoholic (AOR = 0.31; 95% CI 0.13-0.64) and non-smoking (AOR = 0.33; 95% CI 0.15-0.67) were found to be associated with the outcome. The maximum log likelihood estimate value was -30.5 and AIC was 385 for the final model, respectively. Receiver operating characteristic (ROC) curve for the periodontal disease was 0.737. We can conclude that sociodemographic factors and habits were useful for predicting periodontal diseases.
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Affiliation(s)
- Siddharthan Selvaraj
- Faculty of Medicine, Medical Campus, Universiti Sultan Zainal Abidin, Kuala Terengganu, Terengganu 20400, Malaysia;
| | - Nyi Nyi Naing
- Faculty of Medicine, Medical Campus, Universiti Sultan Zainal Abidin, Kuala Terengganu, Terengganu 20400, Malaysia;
- Correspondence:
| | - Nadiah Wan-Arfah
- Faculty of Health Sciences, Universiti Sultan Zainal Abidin, Kuala Terengganu, Terengganu 20400, Malaysia;
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Mao W, Wu B, Chi I, Yang W, Dong X. Acculturation and Subsequent Oral Health Problems Among Foreign-Born Older Chinese Americans: Does Neighborhood Disorder Matter? Res Aging 2021; 44:231-240. [PMID: 34002640 DOI: 10.1177/01640275211018785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES To investigate the relationship between acculturation and subsequent oral health problems in older Chinese Americans and to further test the moderating role of neighborhood disorder in such a relationship. METHODS The working sample included 2,706 foreign-born community-dwelling older Chinese Americans aged 60 years or older who participated in the Population Study of Chinese Elderly in Chicago at baseline between 2011 and 2013 and the 2-year follow-up between 2013 and 2015. Stepwise Poisson regressions with lagged dependent variable were conducted. RESULTS Behavioral acculturation was protective against subsequent oral health problems, and the protective role was stronger among individuals reporting lower levels of neighborhood disorder. Residence in Chinatown was associated with an increase in the risk of subsequent oral health problems. DISCUSSION To reduce oral health symptoms and related burdens, it is important to consider, in practice and policy, the role of acculturation and the neighborhood on subsequent oral health outcomes.
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Affiliation(s)
- Weiyu Mao
- School of Social Work, University of Nevada, Reno, NV, USA
| | - Bei Wu
- Rory Meyers College of Nursing, New York University, NY, USA
| | - Iris Chi
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, USA
| | - Wei Yang
- School of Community Health Sciences, University of Nevada, Reno, NV, USA
| | - XinQi Dong
- Institute for Health, Health Care Policy and Aging Research, Rutgers University, New Brunswick, NJ, USA
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Wu B, Mao W, Qi X, Pei Y. Immigration and Oral Health in Older Adults: An Integrative Approach. J Dent Res 2021; 100:686-692. [PMID: 33541196 DOI: 10.1177/0022034521990649] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
The aim of this study was to develop an integrative framework on aging, immigration, and oral health. The methodology was a critical review that used immigration as a social determinant framework through which to evaluate its impact on the oral health of older immigrants. We reviewed recent empirical evidence on factors related to oral health in older immigrants. In a systematic search across multiple databases, we identified 12 eligible studies in this review. Among the eligible studies, most were conducted among East Asian immigrants (8 articles), followed by non-Hispanic White/European origin (2 articles), Mexican origins (1 article), and Iran and other Middle East regions (1 article). The research revealed knowledge gaps in the evidence base, including the dynamic relationship between acculturation and oral health, the role of environmental factors on oral health for immigrants, psychosocial stressors and their relationship with oral health, and oral health literacy, norms, and attitude to dental care utilization and oral hygiene practices. The development of the integrative framework suggests the pathways/mechanisms through which immigration exerts influences on oral health in later life. This provides opportunities for researchers, practitioners, and policy makers to gain greater insights into the complex associations between immigration and oral health among older adults.
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Affiliation(s)
- B Wu
- Rory Meyers College of Nursing and College of Dentistry, New York University, New York, NY, USA
| | - W Mao
- School of Social Work, University of Nevada, Reno, NV, USA
| | - X Qi
- Rory Meyers College of Nursing, New York University, New York, NY, USA
| | - Y Pei
- Rory Meyers College of Nursing, New York University, New York, NY, USA
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Mao W, Wu B, Chi I, Yang W, Dong X. Neighborhood Cohesion and Oral Health Problems Among Older Chinese American Immigrants: Does Acculturation Make a Difference? THE GERONTOLOGIST 2020; 60:219-228. [PMID: 31565728 DOI: 10.1093/geront/gnz126] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Despite an increasing, yet still limited amount of research on social determinants of oral health, the influences of neighborhood characteristics remain understudied, especially within the context of immigration. Acculturation is multidimensional, and its influences on the oral health of immigrants vary across age and ethnic groups. This study investigated the relationship between neighborhood cohesion and oral health problems among older Chinese American immigrants, and whether and to what extent acculturation indicators moderate the relationship between such cohesion and oral health. METHODS The research design and working sample included 3,157 older Chinese American immigrants aged 60 years or older from the baseline of the Population Study of Chinese Elderly in Chicago. Neighborhood cohesion was measured by a six-item scale. Oral health problems were measured by the presence or absence of such problems. Acculturation included residence in ethnic enclaves, length of stay, and behavioral acculturation. Stepwise logistic regression models with interaction terms (Neighborhood cohesion × Acculturation) were conducted to examine the association between neighborhood cohesion and oral health problems, accounting for sociodemographics, health conditions, and health behaviors. RESULTS Individuals experiencing higher levels of neighborhood cohesion reported a lower likelihood of having oral health problems. The protective effect of neighborhood cohesion against having oral health problems was stronger when individuals resided in ethnic enclaves such as Chinatown. DISCUSSION AND IMPLICATIONS To promote optimal oral health, interventions need to account for individuals' perceptions and levels of integration into their neighborhoods and communities.
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Affiliation(s)
- Weiyu Mao
- School of Social Work, University of Nevada, Reno, Los Angeles
| | - Bei Wu
- Rory Meyers College of Nursing, New York University, Los Angeles
| | - Iris Chi
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles
| | - Wei Yang
- School of Community Health Sciences, University of Nevada, Reno, New Brunswick, New Jersey
| | - Xinqi Dong
- Institute for Health, Health Care Policy and Aging Research, Rutgers University, New Brunswick, New Jersey
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Global Prevalence of Periodontal Disease and Lack of Its Surveillance. ScientificWorldJournal 2020; 2020:2146160. [PMID: 32549797 PMCID: PMC7275199 DOI: 10.1155/2020/2146160] [Citation(s) in RCA: 168] [Impact Index Per Article: 42.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 04/23/2020] [Accepted: 04/28/2020] [Indexed: 01/09/2023] Open
Abstract
Background Periodontal disease is a public health problem and is strongly associated with systemic diseases; however, its worldwide distribution is not fully understood. Objective To evaluate global data of periodontal disease: (1) among adolescents, adults, and older population and (2) in low-, middle-, and high-income countries. Methods This ecological study included data of periodontal disease from the World Health Organization's data bank which are based on the Community Periodontal Index of Treatment Needs (CPITN code: 0 = no disease; 1 = bleeding on probing; 2 = calculus; 3 = periodontal pocket (PD) 4-5 mm; 4 = PD (6+ mm). Age- and income-related periodontal disease inequalities were evaluated across the globe. Results Compared with 9.3% of adults and 9.7% of older persons, 21.2% of adolescents had no periodontal disease (P = 0.005). Nearly 18.8% of adolescents compared with 8.9% of adults and 5% of older persons had bleeding on probing (P ≤ 0.001). Similarly, 50.3% of adolescents, 44.6% of adults, and 31.9% older persons demonstrated the occurrence of calculus (P = 0.01). On the other hand, older persons had the highest prevalence of PD 4-5 mm and PD 6+ mm than adults and adolescents (P ≤ 0.001). The distribution of periodontitis (CPITN code 3 + 4) in adults differed significantly in low- (28.7%), lower-middle- (10%), upper-middle- (42.5%), and high-income countries (43.7%) (P = 0.04). However, no significant differences in periodontitis (CPITN code 3 + 4) were observed in adolescents and older persons in low- to high-income countries. Conclusions Within the limitations of data, this study found that the distribution of periodontal disease increases with age. Periodontitis was the most common in older persons and in population from high-income countries.
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Ababneh KT, Maslamani MJ, Abbadi MS, Taha AH, Karasneh JA, Sa'di AG, Khader YS. Risk indicators of aggressive periodontitis in a Jordanian population. BMC Oral Health 2019; 19:155. [PMID: 31311530 PMCID: PMC6636008 DOI: 10.1186/s12903-019-0826-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2018] [Accepted: 06/19/2019] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Knowledge of the risk indicators of aggressive periodontitis (AgP) will help clinicians to better diagnose the disease, put a treatment plan that involves modification of modifiable risk indicators, understand non-modifiable risk indicators, and may potentially serve as an aid in developing preventive programs. The objective of the present study was to assess risk indicators of aggressive periodontitis (AgP) in Jordan including socio-demographic factors, oral hygiene habits, smoking, family history and parents' consanguinity. METHODS A total of 162 patients (81 AgP and 81 controls), attending the Periodontology clinic at Jordan University of Science and Technology, Dental Teaching Centre, were interviewed and examined. All AgP subjects had full periodontal and radiographic examination. The data recorded included socio-demographic and economic variables, oral hygiene and smoking habits, family history and parents' consanguinity. RESULTS Most AgP patients were young females, had ≤12 years of education, lived in urban areas and brushed their teeth ≥ once daily. Risk indicators of AgP included: age > 35 years, female gender and positive family history. CONCLUSIONS Risk indicators associated with AgP in this study population were: age > 35 years, female gender and positive family history of periodontal disease.
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Affiliation(s)
- Khansa T Ababneh
- Department of Preventive Dental Science, College of Dentistry, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Kingdom of Saudi Arabia
- Previous Department of Preventive Dentistry, Faculty of Dentistry, Jordan University of Science and Technology, Irbid, Jordan
| | | | | | - Anas H Taha
- Private practice, Abu Dhabi, United Arab Emirates
| | - Jumana A Karasneh
- Oral Medicine, and Human Molecular Genetics, Department of Oral surgery, Oral Medicine, Oral Pathology and Radiology, Faculty of Dentistry, and Faculty of Science and Art, Biotechnology and Genetic Engineering Department, Jordan University of Science and Technology, Irbid, Jordan
| | - Amani G Sa'di
- Jordanian Food and Drug administration, Amman, Jordan
| | - Yousef S Khader
- Community Medicine & Public Health, Department of Public Health and Community Medicine, Faculty of Medicine, Jordan University of science and Technology, Irbid, Jordan
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Celeste RK, Oliveira SC, Junges R. Threshold-effect of income on periodontitis and interactions with race/ethnicity and education. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2019; 22:e190001. [PMID: 30652730 DOI: 10.1590/1980-549720190001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2017] [Accepted: 03/21/2018] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES The aims of this study were to explore the shape of the relationship of income and education with periodontal health, and to assess the interactions between them and race/ethnicity. METHOD Individual level data from the Brazilian National Oral Health Survey in 2010 (Pesquisa Nacional de Saúde Bucal-SB Brasil 2010) were obtained for 9,779 subjects. Relations between per capita income and education with periodontal health were smoothed using Locally Weighted Scatter-plot Smoother (Lowess) technique. Multivariable logistic regression was used to assess independent effects of income, education, race/ethnicity adjusted for age, sex and time since last dental appointment. RESULTS Prevalence of adults with moderate to severe and severe periodontitis was 17.6 and 6.5%, respectively. The relationship between periodontal health and income was curvilinear, showing a threshold of no relationship for income levels higher than US$ 600/month. In multivariable analysis, after controlling for covariates, only income was significantly associated with periodontal health. There was no significant interaction of income with race or education, neither between race and education. CONCLUSION The relation between periodontal health and income was curvilinear and indicated the presence of a threshold, supporting income transfer programs. Beyond the threshold, only education presented a negative linear relationship with moderate to severe periodontitis.
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Affiliation(s)
- Roger Keller Celeste
- Department of Preventive and Social Dentistry, Faculty of Dentistry, Universidade Federal do Rio Grande do Sul - Porto Alegre (RS), Brazil
| | - Sara Cioccari Oliveira
- Department of Preventive and Social Dentistry, Faculty of Dentistry, Universidade Federal do Rio Grande do Sul - Porto Alegre (RS), Brazil.,Department of Dental Material Sciences, Academic Centre for Dentistry Amsterdam, Vrije University and University of Amsterdam - Amsterdam, The Netherlands
| | - Roger Junges
- Department of Oral Biology, Faculty of Dentistry, University of Oslo - Oslo, Norway
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Penmetsa G, Gadde P, Raju MAKV, Raju AVR. Awareness, attitude, and prevalence of periodontal diseases in West Godavari District of Andhra Pradesh. JOURNAL OF INDIAN ASSOCIATION OF PUBLIC HEALTH DENTISTRY 2019. [DOI: 10.4103/jiaphd.jiaphd_121_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Association between individual and neighbourhood socioeconomic factors and masticatory efficiency: a cross-sectional analysis of the Paris Prospective Study 3. J Epidemiol Community Health 2017; 72:132-139. [DOI: 10.1136/jech-2017-209593] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2017] [Revised: 10/13/2017] [Accepted: 11/21/2017] [Indexed: 01/21/2023]
Abstract
BackgroundThere is a lack of evidence on the impact of socioeconomic factors on masticatory efficiency. The present study investigates the relationship between individual and neighbourhood socioeconomic factors (main exposure) and the number of masticatory units (MUs) used as surrogate of the masticatory efficiency (main outcome).MethodsIn this cross-sectional study nested in the Paris Prospective Study 3, 4270 adults aged 50–75 and recruited from 13 June 2008 to 31 May 2012 underwent a full-mouth examination. Number of MUs defined as pairs of opposing teeth or dental prostheses allowing mastication, number of missing teeth and gingival inflammation were documented. The individual component of the socioeconomic status was evaluated with an individual multidimensional deprivation score and education level. The neighbourhood component of the socioeconomic status was evaluated with the FDep99 deprivation index. Associations were quantified using marginal models.ResultsIn multivariate analyses, having less than 5 MUs was associated with (1) the most deprived neighbourhoods (OR=2.27 (95% CI 1.63 to 3.17)), (2) less than 12 years of educational attainment (OR=2.20 (95% CI 1.66 to 2.92)) and (3) the highest individual score of deprivation (OR=3.23 (95% CI 2.24 to 4.65)). Associations with education and individual score of deprivation were consistent across the level of neighbourhood deprivation. Comparable associations were observed with the number of missing teeth. Associations with gingival inflammation were of lower magnitude; the relationship was present for deprivation markers but not for education.ConclusionPoor masticatory efficiency is associated with low educational attainment and high deprivation scores.
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Harding A, Gonder U, Robinson SJ, Crean S, Singhrao SK. Exploring the Association between Alzheimer's Disease, Oral Health, Microbial Endocrinology and Nutrition. Front Aging Neurosci 2017; 9:398. [PMID: 29249963 PMCID: PMC5717030 DOI: 10.3389/fnagi.2017.00398] [Citation(s) in RCA: 65] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2017] [Accepted: 11/17/2017] [Indexed: 12/21/2022] Open
Abstract
Longitudinal monitoring of patients suggests a causal link between chronic periodontitis and the development of Alzheimer’s disease (AD). However, the explanation of how periodontitis can lead to dementia remains unclear. A working hypothesis links extrinsic inflammation as a secondary cause of AD. This hypothesis suggests a compromised oral hygiene leads to a dysbiotic oral microbiome whereby Porphyromonas gingivalis, a keystone periodontal pathogen, with its companion species, orchestrates immune subversion in the host. Brushing and chewing on teeth supported by already injured soft tissues leads to bacteremias. As a result, a persistent systemic inflammatory response develops to periodontal pathogens. The pathogens, and the host’s inflammatory response, subsequently lead to the initiation and progression of multiple metabolic and inflammatory co-morbidities, including AD. Insufficient levels of essential micronutrients can lead to microbial dysbiosis through the growth of periodontal pathogens such as demonstrated for P. gingivalis under low hemin bioavailability. An individual’s diet also defines the consortium of microbial communities that take up residency in the oral and gastrointestinal (GI) tract microbiomes. Their imbalance can lead to behavioral changes. For example, probiotics enriched in Lactobacillus genus of bacteria, when ingested, exert some anti-inflammatory influence through common host/bacterial neurochemicals, both locally, and through sensory signaling back to the brain. Early life dietary behaviors may cause an imbalance in the host/microbial endocrinology through a dietary intake incompatible with a healthy GI tract microbiome later in life. This imbalance in host/microbial endocrinology may have a lasting impact on mental health. This observation opens up an opportunity to explore the mechanisms, which may underlie the previously detected relationship between diet, oral/GI microbial communities, to anxiety, cognition and sleep patterns. This review suggests healthy diet based interventions that together with improved life style/behavioral changes may reduce and/or delay the incidence of AD.
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Affiliation(s)
- Alice Harding
- Dementia & Neurodegenerative Diseases Research Group, Faculty of Clinical and Biomedical Sciences, School of Dentistry, University of Central Lancashire, Preston, United Kingdom
| | - Ulrike Gonder
- Nutritionist, Freelance Science Writer, Hünstetten, Germany
| | - Sarita J Robinson
- Faculty of Science and Technology, School of Psychology, University of Central Lancashire, Preston, United Kingdom
| | - StJohn Crean
- Dementia & Neurodegenerative Diseases Research Group, Faculty of Clinical and Biomedical Sciences, School of Dentistry, University of Central Lancashire, Preston, United Kingdom
| | - Sim K Singhrao
- Dementia & Neurodegenerative Diseases Research Group, Faculty of Clinical and Biomedical Sciences, School of Dentistry, University of Central Lancashire, Preston, United Kingdom
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Valente MIB, Vettore MV. Contextual and individual determinants of periodontal disease: Multilevel analysis based on Andersen's model. Community Dent Oral Epidemiol 2017; 46:161-168. [DOI: 10.1111/cdoe.12349] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2017] [Accepted: 10/03/2017] [Indexed: 11/26/2022]
Affiliation(s)
- Maria I. B. Valente
- Unit of Dental Public Health; School of Clinical Dentistry; University of Sheffield; Sheffield UK
- Department of Specific Formation; School of Dentistry; Fluminense Federal University; Nova Friburgo RJ Brazil
| | - Mario V. Vettore
- Unit of Dental Public Health; School of Clinical Dentistry; University of Sheffield; Sheffield UK
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An Umbrella Review Exploring the Effect of Periodontal Treatment in Pregnant Women on the Frequency of Adverse Obstetric Outcomes. J Evid Based Dent Pract 2017; 18:218-239. [PMID: 30077375 DOI: 10.1016/j.jebdp.2017.10.011] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2017] [Revised: 10/27/2017] [Accepted: 10/27/2017] [Indexed: 12/22/2022]
Abstract
OBJECTIVE In the recent years, efforts have been made to reduce epidemiologic indicators of periodontal disease in pregnant women. This umbrella review aims to analyze the systematic reviews/meta-analyses investigating the effect of periodontal therapy in pregnant women on the frequency of obstetric complications (low birth weight, preterm delivery, and preeclampsia) and to identify the gaps in the scientific literature. METHODS A systematic review of systematic reviews with and without meta-analysis of intervention studies was conducted. Quality evaluation and qualitative analysis of the reviews were performed. RESULTS A total of 223 articles were obtained, and 18 of them were included in the analysis, 13 articles included meta-analysis, where 11 were of high quality and 7 of medium quality according to the Assessing the Methodological Quality of Systematic Reviews (AMSTAR) guide. These systematic reviews/meta-analyses included a total of 19 studies (17 randomized clinical trials). Descriptive systematic reviews showed that periodontal therapy has positive effects on reducing the frequency of adverse pregnancy outcomes. In systematic reviews with meta-analysis, overall effect estimators were not significant, although a reduction in the incidence of obstetric complications was observed. Subgroup analysis resulted in significant effects, depending on sociodemographic conditions. CONCLUSIONS Differential findings are not enough to demonstrate that there is a significant reduction in the frequency of adverse pregnancy outcomes in pregnant women receiving periodontal therapy. Possible explanations are related to factors such as the type of studies analyzed, indicator of obstetric complication considered, and specific variables included in the analysis. Many systematic reviews did not address publication bias and did identify gaps in knowledge that require further clarification.
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Hau KPH, Currie BL, Ng SPY, Le N, Poh CFY. Oral health status and possible explanatory factors of an inner-city low-income community. J Dent Sci 2017; 12:49-55. [PMID: 30895023 PMCID: PMC6395230 DOI: 10.1016/j.jds.2016.06.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2016] [Revised: 06/06/2016] [Indexed: 11/19/2022] Open
Abstract
Background/purpose Individuals with low income bear a number of health challenges to healthcare services. Vancouver's Downtown Eastside (DTES) is known to be a low-income community in a metropolitan city. Because it is difficult to reach, the oral health (OH) status of these residents is unknown. The objectives of this study are (1) to design a tool and strategy to collect OH information in a low-income community, (2) to characterize the OH status and related factors among low-income adults, and (3) to identify the explanatory factors for their OH status. Materials and methods Mobile screening clinics were established in the gathering centers of the DTES, and those of 19 years of age or older were recruited. Data were collected through survey interviews and clinical examinations. Potential explanatory factors were investigated by regression analysis. Results The 356 screened participants were mostly males, middle-aged, less educated, and living with low income (≤CAD$20,000/y). About 80% had dental coverage, mostly from public programs (94%). Many (86%) perceived a dental need. Among dentate participants (n = 306), on average, 3.8 decayed, 8.6 missing, 4.9 filled teeth, and a care index of 41.5% were observed. Social factors (barriers to care and length of DTES residence), dental hygiene (brushing/flossing), and personal (hepatitis C virus infection/methadone usage) factors contributed to their care index level. Conclusion This is the first time that comprehensive information regarding OH status has been collected from a low-income, inner-city community in Canada. Further investigations in the challenges and needs in accessing dental care may develop solutions for better OH in similar communities.
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Affiliation(s)
- Keith Pak-Hei Hau
- Faculty of Dentistry, University of British Columbia, Vancouver, BC, Canada
| | - Brenda Lee Currie
- Faculty of Dentistry, University of British Columbia, Vancouver, BC, Canada
| | - Samson Pak-Yan Ng
- Faculty of Dentistry, University of British Columbia, Vancouver, BC, Canada
| | - Nhu Le
- Integrative Oncology and Cancer Control Research, British Columbia Cancer Agency Research Centre, Vancouver, BC, Canada
| | - Catherine Fang-Yeu Poh
- Faculty of Dentistry, University of British Columbia, Vancouver, BC, Canada
- Integrative Oncology and Cancer Control Research, British Columbia Cancer Agency Research Centre, Vancouver, BC, Canada
- Corresponding author. Faculty of Dentistry, Department of Oral Medical and Biological Sciences, University of British Columbia, 2199 Wesbrook Mall, Vancouver, BC, Canada V6T 1Z3.
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Schuch HS, Peres KG, Singh A, Peres MA, Do LG. Socioeconomic position during life and periodontitis in adulthood: a systematic review. Community Dent Oral Epidemiol 2016; 45:201-208. [DOI: 10.1111/cdoe.12278] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2016] [Accepted: 11/27/2016] [Indexed: 11/25/2022]
Affiliation(s)
- Helena Silveira Schuch
- Australian Research Centre for Population Oral Health (ARCPOH); Adelaide Dental School; The University of Adelaide; Adelaide South Australia Australia
| | - Karen G. Peres
- Australian Research Centre for Population Oral Health (ARCPOH); Adelaide Dental School; The University of Adelaide; Adelaide South Australia Australia
| | - Ankur Singh
- Australian Research Centre for Population Oral Health (ARCPOH); Adelaide Dental School; The University of Adelaide; Adelaide South Australia Australia
| | - Marco A. Peres
- Australian Research Centre for Population Oral Health (ARCPOH); Adelaide Dental School; The University of Adelaide; Adelaide South Australia Australia
| | - Loc G. Do
- Australian Research Centre for Population Oral Health (ARCPOH); Adelaide Dental School; The University of Adelaide; Adelaide South Australia Australia
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Sun X, Bernabé E, Liu X, Gallagher JE, Zheng S. Do contextual factors have a role in periodontal disease? J Clin Periodontol 2016; 44:13-21. [DOI: 10.1111/jcpe.12630] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/29/2016] [Indexed: 11/30/2022]
Affiliation(s)
- Xiangyu Sun
- Department of Preventive Dentistry; Peking University School and Hospital of Stomatology, National Engineering Laboratory for Digital and Material Technology of Stomatology; Beijing Key Laboratory of Digital Stomatology; Beijing China
- King's College London Dental Institute at Guy's; King's College and St Thomas' Hospitals, Population and Patient Health Division; London UK
| | - Eduardo Bernabé
- King's College London Dental Institute at Guy's; King's College and St Thomas' Hospitals, Population and Patient Health Division; London UK
| | - Xuenan Liu
- Department of Preventive Dentistry; Peking University School and Hospital of Stomatology, National Engineering Laboratory for Digital and Material Technology of Stomatology; Beijing Key Laboratory of Digital Stomatology; Beijing China
| | - Jennifer E. Gallagher
- King's College London Dental Institute at Guy's; King's College and St Thomas' Hospitals, Population and Patient Health Division; London UK
| | - Shuguo Zheng
- Department of Preventive Dentistry; Peking University School and Hospital of Stomatology, National Engineering Laboratory for Digital and Material Technology of Stomatology; Beijing Key Laboratory of Digital Stomatology; Beijing China
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Ionel A, Lucaciu O, Bondor C, Moga M, Ilea A, Feurdean C, Buhăţel D, Hurubeanu L, Câmpian RS. Assessment of the relationship between periodontal disease and cardiovascular disorders: a questionnaire-based study. Med Pharm Rep 2016; 89:534-541. [PMID: 27857524 PMCID: PMC5111495 DOI: 10.15386/cjmed-639] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2016] [Revised: 03/24/2016] [Accepted: 03/29/2016] [Indexed: 12/23/2022] Open
Abstract
Background and aims Periodontitis is an inflammatory disease, characterized by the loss of connective tissue and alveolar bone. There is an increasing evidence that periodontitis is associated with a number of chronic diseases. The aim of this study was to analyze the correlation between periodontitis and certain systemic diseases by identifying their risk factors in a population from North-West Romania. Methods A questionnaire-based study was conducted on participants ≥45 years of age in 4 dentistry or family medicine practices from the Cluj and Bihor counties, Romania, over a time frame spanning two months. The interviewer-administered questionnaire included 42 items assessing risk factors for periodontal and cardiovascular disease, current diagnostic and medical treatment of the participants, their diet and oral hygiene habits. Results Of 108 participants included in the study, 63 (58.3%) declared a previous diagnosis of periodontitis. A significant difference was observed between the participants with declared diagnosis of periodontitis (PD+) and participants without declared diagnosis of periodontitis (PD−) for fresh fruit consumption (p=0.01) and increased sport activity (p=0.009). A significant difference between groups was observed in the case of smoking duration (p=0.047), participants with >10 years of smoking were more likely to declare a diagnosis of periodontitis. Also, PD+ participants were more likely to have a family history of periodontal disease (p<0.001). Multivariate analyses suggested periodontitis as a predictive variable for atherosclerotic coronary artery disease with an OR of 4.85 (95% confidence interval 1.01–23.29, p=0.049). Conclusion Our study found a statistically significant association between periodontal disease and a known family history of periodontal disorders and smoking duration. Daily intake of fresh fruit and increased sport activities were found to be protective factors against periodontal disease, while periodontitis was found as a risk factor for atherosclerotic cardiovascular disease.
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Affiliation(s)
- Anca Ionel
- Department of Oral Rehabilitation, Oral Health and Dental Office Management, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Ondine Lucaciu
- Department of Oral Rehabilitation, Oral Health and Dental Office Management, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Cosmina Bondor
- Department of Medical Informatics and Biostatistics, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Minodora Moga
- Department of Oral Rehabilitation, Oral Health and Dental Office Management, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Aranka Ilea
- Department of Oral Rehabilitation, Oral Health and Dental Office Management, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Claudia Feurdean
- Department of Oral Rehabilitation, Oral Health and Dental Office Management, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Dan Buhăţel
- Department of Oral Rehabilitation, Oral Health and Dental Office Management, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Lucia Hurubeanu
- Department of Oral and Cranio-Maxillofacial Surgery, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Radu Septimiu Câmpian
- Department of Oral Rehabilitation, Oral Health and Dental Office Management, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
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Prevalence of periodontitis according to Hispanic or Latino background among study participants of the Hispanic Community Health Study/Study of Latinos. J Am Dent Assoc 2016; 145:805-16. [PMID: 25082929 DOI: 10.14219/jada.2014.31] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Hispanics and Latinos are an ethnically heterogeneous population with distinct oral health risk profiles. Few study investigators have examined potential variation in the burden of periodontitis according to Hispanic or Latino background. METHODS The authors used a multicenter longitudinal population-based cohort study to examine the periodontal health status at screening (2008-2011) of 14,006 Hispanic and Latino adults, aged 18 to 74 years, from four U.S. communities who self-identified as Cuban, Dominican, Mexican, Puerto Rican, Central American or South American. The authors present weighted, age-standardized prevalence estimates and corrected standard errors of probing depth (PD), attachment loss (AL) and periodontitis classified according to the case definition established by the Centers for Disease Control and Prevention and the American Academy of Periodontology (CDC-AAP). The authors used a Wald χ(2) test to compare prevalence estimates across Hispanic or Latino background, age and sex. RESULTS Fifty-one percent of all participants had exhibited total periodontitis (mild, moderate or severe) per the CDC-AAP classification. Cubans and Central Americans exhibited the highest prevalence of moderate periodontitis (39.9 percent and 37.2 percent, respectively). Across all ages, Mexicans had the highest prevalence of PD across severity thresholds. Among those aged 18 through 44 years, Dominicans consistently had the lowest prevalence of AL at all severity thresholds. CONCLUSIONS Measures of periodontitis varied significantly by age, sex and Hispanic or Latino background among the four sampled Hispanic Community Health Study/Study of Latinos communities. Further analyses are needed to account for lifestyle, behavioral, demographic and social factors, including those related to acculturation. PRACTICAL IMPLICATIONS Aggregating Hispanics and Latinos or using estimates from Mexicans may lead to substantial underestimation or overestimation of the burden of disease, thus leading to errors in the estimation of needed clinical and public health resources. This information will be useful in informing decisions from public health planning to patient-centered risk assessment.
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Brein DJ, Fleenor TJ, Kim SW, Krupat E. Using the Theory of Planned Behavior to Identify Predictors of Oral Hygiene: A Collection of Unique Behaviors. J Periodontol 2015; 87:312-9. [PMID: 26469810 DOI: 10.1902/jop.2015.150239] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND This study aims to identify predictors of performed oral hygiene behaviors (OHBs) based on the Theory of Planned Behavior (TPB), oral health knowledge, and demographic factors. METHODS Using a questionnaire, 381 participants in three general dental offices and one hospital dental department in York, Pennsylvania, were surveyed regarding performed OHB, attitudes, subjective norms, perceived behavioral control, oral health knowledge, income, age, and sex. RESULTS Three unique elements of OHB were identified for analysis: brushing, interdental cleaning, and tongue cleaning. Regression analysis revealed that attitude was the strongest predictor of brushing behavior, followed by oral health knowledge, perceived behavior control, subjective norms, and income. Perceived behavior control was the strongest predictor of interdental cleaning, followed by increased age and attitude. Female sex was the strongest predictor of tongue cleaning, followed by subjective norms, decreased age, and perceived behavior control. Respectively, these three groups of predictive variables explained 22.5% of brushing behavior, 22.7% of interdental cleaning behavior, and 9.5% of tongue cleaning behavior. CONCLUSIONS The present findings highlight the utility of viewing OHB as a set of unique behaviors with unique predictive variables and provide additional support for use of TPB in predicting OHB. Periodontal practitioners should consider the strong associations of attitude and perceived behavioral control with brushing and interdental cleaning behaviors when designing interventional efforts to improve patient home care.
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Affiliation(s)
| | | | - Soo-Woo Kim
- Department of Oral Medicine, Infection, and Immunology; Harvard School of Dental Medicine
| | - Edward Krupat
- The Center for Evaluation, Harvard Medical School, Boston, MA
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Vettore MV, Aqeeli A. The roles of contextual and individual social determinants of oral health-related quality of life in Brazilian adults. Qual Life Res 2015; 25:1029-42. [DOI: 10.1007/s11136-015-1118-0] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/26/2015] [Indexed: 11/29/2022]
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Kaur S, Khurana P, Kaur H. A survey on acquaintance, orientation and behavior of general medical practitioners toward periodontal diseases. J Indian Soc Periodontol 2015; 19:322-6. [PMID: 26229276 PMCID: PMC4520120 DOI: 10.4103/0972-124x.154545] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2014] [Accepted: 02/26/2015] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND An association between oral conditions such as periodontal diseases and systemic conditions is noted. As such, periodontal disease is associated with an increased risk of systemic illnesses such as cardiovascular disease, diabetes, adverse pregnancy outcome, atherosclerosis, stroke and hospital acquired pneumonia. The concept of diagnosing and treating a potential patient to minimize the deleterious effects of this chronic infectious and inflammatory condition on systemic conditions represents both an unprecedented challenge and opportunity to our profession. Keeping this in view, the present survey was designed to evaluate the acquaintance, orientation and behavior of general medical practitioners; concerning the effects of periodontal disease on systemic health. MATERIALS AND METHODS A typed questionnaire carrying four sets of questions was distributed among general medical practitioners of seven different government and private medical colleges and hospitals. Questionnaire was developed to assess the acquaintance, orientation and behavior of general medical practitioners toward periodontal disease. RESULTS Most of the respondents have knowledge regarding the signs and symptoms of periodontal disease and its association with cardiovascular disease. However, majority of them do not know about the potential effect of periodontal disease on other organ systems. CONCLUSION General medical practitioners have inadequate knowledge regarding periodontal diseases. Hence, oral health related training should be an integral part of the medical curriculum.
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Affiliation(s)
- Supreet Kaur
- Department of Periodontics, Sri Guru Ram Das Institute of Dental Sciences and Research, Amritsar, Punjab, India
| | - Pankaj Khurana
- Department of Dentistry, Government Medical College and Hospital, Chandigarh, India
| | - Harjit Kaur
- Department of Periodontics and Community Dentistry, Guru Nanak Dev Dental College and Research Institute, Sunam, Punjab, India
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Lee C, Huang H, Sun T, Karimbux N. Impact of Patient Compliance on Tooth Loss during Supportive Periodontal Therapy. J Dent Res 2015; 94:777-86. [DOI: 10.1177/0022034515578910] [Citation(s) in RCA: 83] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Periodontal treatment consists of active periodontal therapy (APT) and supportive periodontal therapy (SPT). Regular SPT is recommended to prevent and control the occurrence of periodontal disease following APT. A patient’s compliance with SPT is considered one of the most important factors affecting long-term periodontal status. Tooth loss is generally considered the final outcome of periodontitis. This review aimed to analyze the relationship between patient compliance with regular SPT and tooth loss. The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guideline for systematic reviews was used. A search of articles was conducted using MEDLINE (PubMed) and other databases. Quality assessments of selected studies were performed. To assess the effect of compliance on tooth loss during SPT, pooled risk ratio of tooth loss (RRTL) was used as the primary outcome. Pooled risk difference of tooth loss (RDTL) and weighted mean difference of tooth loss rate (WDTLR) were used as secondary outcomes. Subgroup analysis and meta-regression were conducted to evaluate the effects of different variables. In total, 710 articles were screened. Eight studies, which had a regular-compliance (RC) group and an erratic-compliance (EC) group with at least a 5-y follow-up period, qualified for the meta-analysis. The risk of tooth loss in the RC group was significantly lower than that in the EC group (pooled RRTL: 0.56 [confidence interval (CI): 0.38, 0.82]; pooled RDTL: –0.05 [CI: –0.08, –0.01]). The definition of compliance was a variable significantly related to risk ratio of tooth loss. Patients in the RC group had significantly lower tooth loss rate during SPT than did patients in the EC group (WDTLR: –0.12 [CI: –0.19, –0.05]). Teeth have less risk of being lost if patients are more compliant with supportive periodontal therapy. However, unidentified variables causing data heterogeneity and affecting the risk of tooth loss may have been present. More well-controlled prospective studies are needed in the future.
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Affiliation(s)
- C.T. Lee
- Division of Periodontology, Department of Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine, Boston, MA, USA
| | - H.Y. Huang
- School of Dentistry, National Defense Medical Center, Taipei, Taiwan
| | - T.C. Sun
- Department of Periodontology, Tufts University School of Dental Medicine, Boston, MA, USA
| | - N. Karimbux
- Department of Periodontology, Tufts University School of Dental Medicine, Boston, MA, USA
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DeBaz C, Shamia H, Hahn J, Mithani S, Sadeghi G, Palomo L. Periodontitis impacts quality of life in postmenopausal women. Climacteric 2015; 18:637-42. [PMID: 25553806 DOI: 10.3109/13697137.2014.996124] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
AIM Interrelationships between traditional dental variables are becoming more evident in far-reaching aspects of life such as psychosocial interaction, self-esteem, overall health and even occupational performance. This study compares quality of life in postmenopausal women with chronic periodontitis with that of healthy postmenopausal women. METHOD A total of 128 randomly recruited postmenopausal women received a comprehensive periodontal evaluation and completed the Utian Quality of Life Survey. The participants were divided into healthy and periodontitis groups based on comprehensive periodontal examination. Mean scores were calculated for each quality-of-life item, domain and the overall summary score. Periodontitis patients' quality-of-life outcomes were compared to those of healthy patients using the t-test with threshold of significance at p < 0.05. RESULTS Quality-of-life scores in all fields measured were significantly poorer in the periodontitis patients compared to the healthy patients, occupational (25.74 ± 8.25 vs. 21.40 ± 9.19), health (26.46 ± 5.93 vs. 19.64 ± 10.24), emotional (21.04 ± 10.20 vs. 16.40 ± 10.84), sexual (9.23 ± 4.92 vs. 5.96 ± 5.20), and total score (82.48 ± 23.74 vs. 63.69 ± 26.61). CONCLUSION This study has identified that postmenopausal women with chronic periodontitis report significantly poorer quality of life than healthy patients. Clinicians caring for postmenopausal women should be aware that periodontitis also impacts quality of life when making referral decisions for oral health care.
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Affiliation(s)
- C DeBaz
- Department of Periodontology, School of Dental Medicine, Case Western Reserve University , Cleveland, Ohio , USA
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Interleukin-6 c.-174G>C Polymorphism and Periodontitis in a Brazilian Population. Mol Biol Int 2014; 2014:490308. [PMID: 25548674 PMCID: PMC4274816 DOI: 10.1155/2014/490308] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2014] [Revised: 11/12/2014] [Accepted: 11/19/2014] [Indexed: 02/05/2023] Open
Abstract
Aim. Periodontitis is an inflammatory disease that affects the teeth supporting structures, triggered by periodontal pathogens, and is influenced by environmental and genetic factors. Genes encoding molecules related to the immune response, such as cytokine, are the main candidates for polymorphisms analysis and may be possibly associated with this pathology. A G/C promoter polymorphism on the IL6 gene has been shown to affect basal IL-6 levels. The aim of this study was to investigate the association between the IL6 c.-174G>C polymorphism and periodontitis in individuals from Vitória da Conquista, Bahia, Brazil. Material and Methods. Three hundred and thirty individuals (134 cases, 196 controls) were genotyped for the IL6 c.-174G>C by MS-PCR technique. Concentrations of salivary IL-6 were determined by ELISA method. Results. The IL6 c.-174G>C polymorphism was associated with periodontitis when comparing the distribution of genotypes between patients with periodontitis and control subjects. The GC genotype appeared as a protective factor for periodontitis. Results showed increased levels of salivary IL-6 in periodontitis patients. Nevertheless, there was no relationship between the concentrations of IL-6 and genotypes when comparing the case and control groups. Conclusions. Our data indicate an association between IL6 c.-174G>C polymorphism and periodontitis and showed that IL-6 may be considered an important marker for periodontitis.
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Vano M, Gennai S, Karapetsa D, Miceli M, Giuca MR, Gabriele M, Graziani F. The influence of educational level and oral hygiene behaviours on DMFT index and CPITN index in an adult Italian population: an epidemiological study. Int J Dent Hyg 2014; 13:151-7. [PMID: 25040938 DOI: 10.1111/idh.12098] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/12/2014] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To estimate the influence of educational level and oral hygiene behaviours on the prevalence and severity of dental caries and periodontal disease in an adult Italian population attending the Oral Hygiene department of a public Dental Clinic. METHODS Dental caries was diagnosed according to the World Health Organization criteria. The DMFT index (decayed, missing, filled tooth) was used to record the dental caries' experience. The periodontal status was assessed using the community periodontal index of treatment needs (CPITN). Questionnaires on educational level and oral hygiene behaviours were also collected. RESULTS A total of 350 patients were enrolled. The mean DMFT value reported was 4.37 ± 3.06, and higher values were observed for male patients (P < 0.05). Increased CPITN scores and DMFT values were significantly correlated with lower level of education (P < 0.05). Subjects of high educational status showed significantly better oral hygiene habits (P < 0.05). CONCLUSIONS The oral health status, in terms of periodontal disease and dental caries, appears correlated with patients' educational level.
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Affiliation(s)
- M Vano
- Department of Surgical Pathology, Medicine, Molecular and Critical Area, University of Pisa, Pisa, Italy
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Xie Y, Xiong X, Elkind-Hirsch KE, Pridjian G, Maney P, Delarosa RL, Buekens P. Prepregnancy Obesity and Periodontitis Among Pregnant Females With and Without Gestational Diabetes Mellitus. J Periodontol 2014; 85:890-8. [DOI: 10.1902/jop.2013.130502] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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Nanaiah KP, Nagarathna DV, Manjunath N. Prevalence of periodontitis among the adolescents aged 15-18 years in Mangalore City: An epidemiological and microbiological study. J Indian Soc Periodontol 2014; 17:784-9. [PMID: 24554891 PMCID: PMC3917211 DOI: 10.4103/0972-124x.124507] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2013] [Accepted: 07/18/2013] [Indexed: 11/13/2022] Open
Abstract
Background: Periodontitis is a group of inflammatory diseases affecting the supporting tissues of the tooth. Both aggressive periodontitis (AP) and chronic periodontitis (CP) have a multifactorial etiology, with dental plaque as the initiating factor. However, the initiation and progression of periodontitis are influenced by other factors including microbiologic, social and behavioral and systemic and genetic factors. The prevalence of periodontal diseases varies in different regions of the world according to the definition of periodontitis and the study population, and there are indications that they may be more prevalent in developing than in developed countries. Materials and Methods: A cross-sectional study was conducted among the adolescents of 15-18 years of age in Mangalore City. One thousand one hundred students aged 15-18 years were selected for the study from the schools and colleges in Mangalore City using a convenient sampling method. The prevalence of AP and CP were assessed in the study using a community periodontal index. Students who were diagnosed clinically and radiographically were subjected to microbiological examination to confirm AP. Results: A high prevalence of gingivitis and periodontitis was found in students belonging to the lower socioeconomic status group compared with the higher socioeconomic groups, which were associated with poor oral hygiene habits. The prevalence of AP was found to be 0.36% and that of CP was found to be 1.5%. Conclusion: Oral diseases have a significant impact on the social and psychological aspects of an individual's life. Exposure to risk factors, such as age, low socio-economic status, poor education, low dental care utilization, poor oral hygiene levels, smoking, psychosocial stress and genetic factors are significantly associated with an increased risk of periodontitis among adolescents. Although genetic factors play a major role in periodontitis, the treatment outcome will still be influenced by environmental and behavioral factors.
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Affiliation(s)
- K Pallavi Nanaiah
- Department of Periodontics, Dayananda Sagar College of Dental Sciences, Bangalore, Karnataka, India
| | - D V Nagarathna
- Department of Periodontics, A. J. Institute of Dental Sciences, Mangalore, Karnataka, India
| | - Nandini Manjunath
- Department of Periodontics, A. J. Institute of Dental Sciences, Mangalore, Karnataka, India
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Haas AN, Wagner MC, Oppermann RV, Rösing CK, Albandar JM, Susin C. Risk factors for the progression of periodontal attachment loss: a 5-year population-based study in South Brazil. J Clin Periodontol 2014; 41:215-23. [DOI: 10.1111/jcpe.12213] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/28/2013] [Indexed: 11/29/2022]
Affiliation(s)
- Alex Nogueira Haas
- Department of Periodontology; Faculty of Dentistry; Federal University of Rio Grande do Sul; Porto Alegre Brazil
| | - Marcius Comparsi Wagner
- Department of Periodontology; Faculty of Dentistry; Federal University of Rio Grande do Sul; Porto Alegre Brazil
| | - Rui Vicente Oppermann
- Department of Periodontology; Faculty of Dentistry; Federal University of Rio Grande do Sul; Porto Alegre Brazil
| | - Cassiano Kuchenbecker Rösing
- Department of Periodontology; Faculty of Dentistry; Federal University of Rio Grande do Sul; Porto Alegre Brazil
| | - Jasim M. Albandar
- Periodontal Diagnostics Research Laboratory; Department of Periodontology and Oral Implantology; Temple University School of Dentistry; Philadelphia PA USA
| | - Cristiano Susin
- Department of Periodontics and Oral Biology; College of Dental Medicine; Georgia Regents University; Augusta GA USA
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Vettore MV, Marques RADA, Peres MA. Desigualdades sociais e doença periodontal no estudo SBBrasil 2010: abordagem multinível. Rev Saude Publica 2013; 47 Suppl 3:29-39. [DOI: 10.1590/s0034-8910.2013047004422] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2012] [Accepted: 03/20/2013] [Indexed: 11/22/2022] Open
Abstract
OBJETIVO: Estimar a prevalência e a distribuição geográfica da doença periodontal na população adulta brasileira e sua associação com desigualdades sociais contextuais e individuais. MÉTODOS: Foram utilizados dados dos adultos de 35 a 44 anos de idade da Pesquisa Nacional de Saúde Bucal – SBBrasil 2010 (n = 9.564). O Índice Periodontal Comunitário (CPI) e o Índice de Perda Periodontal (PIP) foram usados para definir a doença periodontal em “moderada a grave” (CPI > 2 e PIP > 0) e “grave” (CPI > 2 e PIP > 1). As desigualdades sociais contextuais incluíram o índice de desenvolvimento humano e a desigualdade de renda (Índice de Gini). Outras variáveis contextuais foram a cobertura de equipes de saúde bucal da Estratégia de Saúde da Família e o percentual de adultos fumantes. Modelos de regressão logística multinível para os participantes com dados completos (n = 4.594) foram usados para estimar odds ratios (OR) e intervalos de 95% de confiança (IC95%) entre desigualdades sociais e doença periodontal. RESULTADOS: A prevalência da doença periodontal “moderada a grave” em brasileiros adultos foi de 15,3% e 5,8% para a condição “grave”, com variações consideráveis entre os municípios. Dentre as variáveis contextuais, a desigualdade de renda foi independentemente associada com a doença periodontal “grave” (OR = 3,0; IC95% 1,5;5,9). A menor cobertura de equipes de saúde bucal foi associada com as duas formas de doença periodontal, enquanto o percentual de fumantes manteve-se associado com a doença periodontal “moderada a grave”. Adultos com idade mais avançada, de cor de pele parda, sexo masculino, menor renda familiar e menor escolaridade apresentaram maiores chances para ambas as condições periodontais investigadas. CONCLUSÕES: No Brasil, a prevalência da doença periodontal variou conforme o município e a definição de doença empregada. A desigualdade de renda teve um papel importante na ocorrência da doença periodontal “grave”. Características individuais de posição social foram associadas com as duas formas de doença periodontal.
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Affiliation(s)
| | | | - Marco A Peres
- University of Adelaide, Australia; Departamento de Saúde Pública, Universidade Federal de Santa Catarina, Brasil
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Borenstein H, Renahy E, Quiñonez C, O'Campo P. Oral health, oral pain, and visits to the dentist: neighborhood influences among a large diverse urban sample of adults. J Urban Health 2013; 90:1064-78. [PMID: 23615780 PMCID: PMC3853181 DOI: 10.1007/s11524-013-9802-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
The objective of this study was to assess the association between oral health and individual-level characteristics as well as both socioeconomic position (SEP) and service provision characteristics at the neighborhood level. Multilevel logistic analysis was undertaken of data from the Neighbourhood Effects on Health and Well-being Study in Toronto comprising 2,412 participants living in 47 neighborhoods and 87 census tracts. Three oral health outcomes were investigated: last dental visit, self-rated oral health, and self-rated oral pain. Results indicated that SEP was significantly associated with no dental visits in the last year, poor self-rated oral health, and experiencing oral pain after adjusting for age, gender, and immigrant status. Lack of dental insurance was associated with no visits to the dentist in the last year and poor self-rated oral health; however, no association was observed with oral pain. In adjusted regression models, few neighborhood level variables were significantly associated with dental visits and self-rated oral health and no neighborhood variables were associated with oral pain. Based on these results, SEP appears to be important in evaluating oral health outcomes. While insignificant in this study, neighborhood factors are important when considering the impact of service provision on oral health.
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Affiliation(s)
- Heidi Borenstein
- Centre for Research on Inner City Health, St. Michael's Hospital, 209 Victoria Street, Third Floor, Toronto, Ontario, Canada, M5C 1N8,
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Efficacy of various side-to-side toothbrushes for noncontact biofilm removal. Clin Oral Investig 2013; 18:793-800. [DOI: 10.1007/s00784-013-1047-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2013] [Accepted: 07/03/2013] [Indexed: 10/26/2022]
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Yahaya I, de Leon AP, Uthman OA, Soares J, Macassa G. Individual and community-level socioeconomic position and its association with adolescents experience of childhood sexual abuse: a multilevel analysis of six countries in Sub-Saharan Africa. J Inj Violence Res 2013; 6:21-30. [PMID: 23797565 PMCID: PMC3865452 DOI: 10.5249/jivr.v6i1.316] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2012] [Accepted: 05/29/2013] [Indexed: 11/09/2022] Open
Abstract
Background: Childhood sexual abuse (CSA) is a substantial global health and human rights problem and consequently a growing concern in sub-Saharan Africa. We examined the association between individual and community-level socioeconomic status (SES) and the likelihood of reporting CSA. Methods: We applied multiple multilevel logistic regression analysis on Demographic and Health Survey data for 6,351 female adolescents between the ages of 15 and 18 years from six countries in sub-Saharan Africa, between 2006 and 2008. Results: About 70% of the reported cases of CSA were between 14 and 17 years. Zambia had the highest proportion of reported cases of CSA (5.8%). At the individual and community level, we found that there was no association between CSA and socioeconomic position. This study provides evidence that the likelihood of reporting CSA cut across all individual SES as well as all community socioeconomic strata. Conclusions: We found no evidence of socioeconomic differentials in adolescents’ experience of CSA, suggesting that adolescents from the six countries studied experienced CSA regardless of their individual and community-level socioeconomic position. However, we found some evidence of geographical clustering, adolescents in the same community are subject to common contextual influences. Further studies are needed to explore possible effects of countries’ political, social, economic, legal, and cultural impact on childhood sexual abuse.
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Affiliation(s)
- Ismail Yahaya
- Department of Public Health Sciences, Midsweden University, Sweden.
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Bonfim MDLC, Mattos FF, Ferreira EFE, Campos ACV, Vargas AMD. Social determinants of health and periodontal disease in Brazilian adults: a cross-sectional study. BMC Oral Health 2013; 13:22. [PMID: 23688161 PMCID: PMC3663668 DOI: 10.1186/1472-6831-13-22] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2013] [Accepted: 05/07/2013] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Recently, increasing importance has been placed on the social determinants of health and disease. The present study aimed to determine the prevalence of periodontal disease in Brazilian adults and identify possible relationships with social determinants. METHODS A cross-sectional study was performed using a sample of 743 adults (aged 35-49 years) living in an urban area of a large city in southeastern Brazil. The condition of the periodontium was assessed using the Community Periodontal Index (CPI) according to the diagnostic criteria established by the World Health Organization (WHO). The variables related to social determinants were collected using a structured questionnaire. A descriptive analysis of all study variables was performed. Multiple correspondence analysis was subsequently performed to identify relationships between periodontal disease and the social determinants of health. RESULTS The periodontal exams showed that 36.5% of adults had a healthy periodontium, 2.0% had gingival bleeding, 47.1% had calculus and 9.5% had periodontal pockets of 4-5 mm. Periodontal pockets of 6 mm or more were the worst periodontal condition found (affecting only 2.1% of the participants). The correspondence analysis enabled us to form three groups with different profiles. The first group was distinguished by the presence of bleeding (gingivitis) or a healthy periodontium. The members of this group were typically aged 35 to 39 years and had 9-12 years or more than 12 years of education. The second group consisted of subjects with calculus and periodontal pockets of 4-5 mm. The members of this group were typically white men aged 40-44 years with incomes greater than $ 300.00. The third group was distinguished by the presence of periodontal pockets of 6 mm or more. The members of this group were typically adult females, black and mixed individuals who had 8 years or less of schooling, individuals with incomes ≤ $ 300.00 and widowers. CONCLUSION The results suggest that periodontal health is worse in the group for which the social indicators are worse. Therefore, the social determinants of health also affect the severity of periodontal disease in adults Brazilian society.
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Affiliation(s)
| | - Flavio Freitas Mattos
- Department of Community and Preventive Dentistry, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
| | - Efigênia Ferreira e Ferreira
- Department of Community and Preventive Dentistry, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
| | - Ana Cristina Viana Campos
- Postgradute Program in Dentistry, Department of Community and Preventive Dentistry, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
| | - Andréa Maria Duarte Vargas
- Department of Community and Preventive Dentistry, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
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Abstract
Periodontal diseases are highly prevalent, particularly amongst socially disadvantaged populations, impact on quality of life and are costly to treat. Clinical treatments and chairside preventive approaches alone will never adequately address this problem. Indeed in many parts of the developing world clinical care and chairside prevention are both unaffordable and inappropriate for the control of periodontal diseases. A paradigm shift away from the individualized treatment approach to a population public health model is needed to promote periodontal health and, in particular to address social inequalities in periodontal status. Public health measures need to focus on the underlying determinants of periodontal diseases. Poor hygiene, tobacco use, psychosocial factors and related systemic diseases are the main risk factors for periodontal diseases. Public health interventions need to tackle these factors but also must recognize and act upon the distal underlying influences that determine and pattern these identified risks. Recognition also needs to be placed on the interlinking and common risk factors shared by periodontal diseases and other chronic conditions. A complementary range of public health policies acting at local, regional, national and international levels need to be implemented to achieve sustainable improvements in oral health. To be effective these policies need to link across the broader public health agenda and require public engagement and support. Clinicians, public health practitioners, commercial organizations and professional groups all have an important role to play in promoting periodontal health.
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Wehmeyer MMH, Corwin CL, Guthmiller JM, Lee JY. The impact of oral health literacy on periodontal health status. J Public Health Dent 2012; 74:80-7. [PMID: 23121152 DOI: 10.1111/j.1752-7325.2012.00375.x] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2011] [Accepted: 09/25/2012] [Indexed: 12/01/2022]
Abstract
OBJECTIVE The objective of this study was to describe oral health literacy (OHL) among periodontal patients and to examine its association with periodontal health status. METHODS This cross-sectional study included new and referred patients presenting to the University of North Carolina Graduate Periodontology Clinic. Sociodemographic and dental history information were collected. OHL was measured using a dental word recognition instrument, Rapid Estimate of Adult Literacy-30 (REALD-30). Clinical periodontal examinations were completed. RESULTS One hundred and twenty-eight participants enrolled and 121 completed all study examinations and instruments. Despite a high level of education among participants in our study, low levels of OHL were found in one-third (33 percent) of the study population. Thirty-one percent had moderate OHL (score of 22-25), 37 percent had high OHL (score ≥ 26). The mean REALD-30 score was 23. Fifty-three percent of participants had severe periodontitis, 29 percent had moderate periodontitis, and 18 percent had mild or no periodontitis. Bivariate analysis showed a significant association between OHL and periodontal status (P < 0.05). The effect of OHL on periodontal health status remained statistically significant (P < 0.002) even after controlling for smoking, race, and dental insurance. CONCLUSION Lower OHL was associated with more severe periodontal disease among new and referred patients presenting to the University of North Carolina Graduate Periodontology Clinics.
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Affiliation(s)
- Meggan M H Wehmeyer
- Department of Periodontics and Dental Hygiene, University of Texas Health Science Center at Houston School of Dentistry, Houston, TX, USA
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Borrell LN, Talih M. Examining periodontal disease disparities among U.S. adults 20 years of age and older: NHANES III (1988-1994) and NHANES 1999-2004. Public Health Rep 2012; 127:497-506. [PMID: 22942467 PMCID: PMC3407849 DOI: 10.1177/003335491212700505] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE We examined disparities in periodontal disease in U.S. adults according to age, sex, race/ethnicity, country of birth, education, income, and poverty-income ratio within and between the third National Health and Nutrition Examination Survey (NHANES III, 1988-1994) and NHANES 1999-2004. METHODS We assessed disparities and changes therein using prevalence differences and ratios, as well as the Symmetrized Theil Index (STI). While these measures document disparities between pairs of population subgroups, and changes in relative disparities between surveys, the STI is a summary measure of health disparities that also tracks between-group disparities relative to the total population. RESULTS Prevalence differences and ratios for the prevalence of periodontitis, the mean pocket depth (PD), and the mean clinical attachment loss (CAL) suggest that periodontal disease significantly decreased between NHANES III and NHANES 1999-2004 (p<0.01). However, the STI for the prevalence of periodontitis suggests that disparities significantly increased within categories of race/ethnicity, country of birth, and education in NHANES 1999-2004 compared with NHANES III. These findings were corroborated for mean PD and mean CAL (p<0.001): the overall STI significantly increased for mean PD from 4.53% in NHANES III to 11.02% in NHANES 1999-2004 and for mean CAL for teeth with CAL >0 from 31.73% in NHANES III to 43.36% in NHANES 1999-2004. CONCLUSIONS Our findings suggest that inequalities in periodontal disease significantly decreased between NHANES III and NHANES 1999-2004 in the total population and across selected characteristics of the population. However, these inequalities increased within groups of the population in NHANES 1999-2004 compared with NHANES III. These findings call attention to the absolute and relative differences not only between population groups across surveys, but also within population groups within and between surveys.
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Affiliation(s)
- Luisa N Borrell
- The City University of New York, Lehman College, Department of Health Sciences, New York, NY 10468, USA.
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